| NPI | 1669244760 |
|---|---|
| Doing Business As | PHOENIX RESIDENTIAL BEHAVIORAL HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | USMAN JAWA BUNDU Director 148-097-7945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |